Medicare enrollment can often be confusing, and adding Medicare Advantage plans only adds to the confusion. Do you enroll in Original Medicare, add a prescription drug plan, or sign up for an Advantage plan?
Medicare Advantage plans have many benefits. They allow you to manage all your healthcare plans in one place, and many provide additional coverage outside of regular Medicare benefits. Since the providers are private insurance companies, they get to set their monthly premiums, copayment amounts, and deductibles in most cases.
So, how do you decide which plan is right for you? There are many factors to consider, so keep reading as we give you the best Medicare Advantage plan options.
Best Medicare Advantage Plans
Medicare Advantage plans allow you to combine the coverage of Medicare Part A, Medicare Part B, and prescription drug coverage (Medicare Part D) into a single program. These plans are sometimes still referred to as Medicare Part C plans. They are managed and maintained by private insurance companies that contract with Medicare. As such, these companies decide on the coverage details for most of these plans. There are many factors to consider when choosing the best fit for your situation.
- First, you should examine the monthly premiums. Some plans have no premium, while others have higher premiums.
- Deductible amounts and copays also play a significant role in your decision. If you rarely visit the doctor, then a higher deductible might be OK in your situation.
- Make sure to review the covered services included in the plan, as that can greatly affect your out-of-pocket costs.
- Another factor to consider when evaluating these plans is their healthcare provider network. If your doctors are outside the health plan network, it will likely not be a good choice for you.
- Finally, many insurance plans provide extra benefits not typically included in regular Medicare coverage. For example, the plan might provide dental coverage or vision coverage. If those are things you need, you should try to find a plan that provides them.
It is also essential to review the plan’s star rating before enrolling. Each year, the Center For Medicare and Medicaid Services releases a rating for each Medicare Advantage plan. The rating system uses a scale of one to five stars, and the ratings are based on the experiences of those enrolled in those plans. One star equals poor performance, while a five-star rating equals excellent performance. While we are unable to know your specific situation, here is our list of the best Medicare Advantage plans.
KEY TAKEAWAYS
- Medicare Advantage allows you to manage all your healthcare plans in one place, and many provide additional coverage outside regular Medicare.
- When choosing a Medicare Advantage plan, it is important to consider many factors such as monthly premiums, deductibles, covered services, provider network, and extra benefits.
- There are several types of Medicare Advantage plans, HMOs, PPOs, SNPs, PFFS, MSA, and HMO-POSs, each with different features.
Best Overall: Aetna
Aetna, the country’s fourth-largest provider of Medicare Advantage plans, stands out as our top overall pick due to its extensive educational resources. These resources, covering a wide range of topics from Medicare basics to plan selection, empower you with the knowledge to make informed decisions about your healthcare.
Complementing its educational resources, Aetna offers a vast network of providers and a diverse range of plan options. Whether you favor the structure of an HMO or the adaptability of a PPO, Aetna has a plan that aligns with your unique needs. Some plans come with no premium, while others provide additional benefits, ensuring you can find a plan that suits your budget and lifestyle.
Annual wellness visits are included in these plans, as are hearing and vision checkups and Part D coverage. As part of these plans, the Silver Sneakers program also allows you to receive free or discounted gym memberships. Aetna also provides dual special needs plans for those who qualify for Medicare and Medicaid coverage.
If you decide to enroll, Aetna’s plans offer access to a host of additional perks and benefits, such as over-the-counter medicines and home meal delivery after a hospital stay. Aetna simplifies the process of finding coverage and providers in your area. You can even access concierge services that will aid you in locating providers in your area. Lastly, Aetna’s high customer satisfaction rating of 3.8 stars underscores its commitment to providing excellent service. This makes it an excellent choice for Medicare beneficiaries enrolling in an Advantage plan.
Best For Network Size: UnitedHealthcare
UnitedHealthcare stands out for its extensive network of over one million providers across the country. The flexibility of their coverage options allows you to choose a preferred provider organization (PPO) plan if needed, which offers better coverage for out-of-network visits. This flexibility ensures that you can find a plan that suits your specific healthcare needs.
UnitedHealthcare also partners with AARP to insure all products with the AARP name, and this partnership provides several great bonuses to new members. In addition, you can receive telehealth visits with no copay and annual in-home wellness exams. Many add-on benefits are available, like mental health coverage, free gym memberships, and coverage for over-the-counter items and medication.
While the network size is a massive plus for UnitedHealthcare plans, customer satisfaction has declined recently. According to a recent J.D. Power survey, their customer satisfaction is lower than the industry standard. However, according to the annual Medicare report, they are still rated an average of 4.2 Medicare stars. This means that most people enrolled in their plans have a good experience and are satisfied overall.
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Best For Member Satisfaction: Kaiser Permanente
When it comes to member satisfaction, Kaiser is the hands-down favorite. It received an average of five stars in the latest Medicare ratings. Only 7 Medicare plans received five stars from the National Committee for Quality Assurance, four of which were Kaiser plans. That speaks to how much customers love the company and their health plans.
Though many people have not heard of Kaiser, they are the country’s 5th largest provider of Medicare plans. They have nearly 2 million members enrolled in their plans, and they have several different options available. Many of their plans have a zero deductible, so you get cost-sharing benefits immediately as soon as you enroll. Enrollees may also choose to add hearing, vision, and dental benefits to their plan.
While Kaiser’s plans offer many benefits, there are a couple of trade-offs to consider. First, they tend to be more expensive than other plans, with monthly premiums averaging about $50. However, this higher cost is often justified by the more affordable health services they provide. For instance, copays are extremely reasonable, with a doctor visit typically costing only about $15 and an emergency room visit usually less than $100. These copays and deductibles are particularly affordable for HMO plans.
One potential drawback of Kaiser’s plans is their limited availability. Currently, they are only offered in eight states and the District of Columbia. However, this limited network can also be seen as a benefit. It allows centralized healthcare management, with all medical records and insurance information stored in one place. This can be a significant advantage for those who value streamlined healthcare administration.
Best For Low-Cost Plans: Humana
If you need a low-cost plan, Humana likely has an offering that will work for you. They offer many plans with a zero-dollar premium, which are available in 47 different states. That is even lower than the regular Medicare Part B premium itself. The company even states that over half its members are enrolled in a zero-premium plan. Their service area covers more Americans than any other plan in the country.
In addition to zero premiums, Humana plans offer some of the lowest out-of-pocket maximums in the market. Many of their plans have an out-of-pocket limit of only $2,200. Their plans are also highly rated. Some have received a full five stars, and these five-star plans have special enrollment periods. This means that if you did not sign up for a five-star plan during the regular open enrollment period, you could still switch to that plan during the special enrollment.
Despite being low cost, Humana’s plans are packed with numerous benefits, including Silver Sneakers, gym membership, acupuncture, massage, mental health care, and exercise class availability. Humana also boasts some of the highest customer satisfaction scores for mail-in prescription drugs. Their overall customer satisfaction rates with all their different types of Medicare Advantage plans are slightly above the industry average.
If you’re looking for a low-cost health care plan that provides access to many great benefits, Humana is definitely worth considering. One of the few drawbacks of Humana is its fairly limited access to special needs plans. If this is a crucial factor for you, you might choose to explore other options.
Best For Bonuses & Perks: Cigna
If you are looking for plans that include bonuses and additional benefits, then Cigna has you covered. In addition to traditional coverage, Cigna offers plans that provide many added benefits. They include many traditional perks like vision, dental, hearing, and fitness memberships. But they also include extra bonuses like meal delivery, health and wellness discounts, and allowances for over-the-counter items like medicine and vitamins.
With Cigna, you’re not just getting a health insurance plan; you’re getting peace of mind. Their customer satisfaction score is higher than the industry average, and they offer a complete suite of online tools to manage your account, find educational materials, and get help. But what truly sets them apart is their 24/7 access to telehealth services. No matter the time of day, a doctor is just a call away, ensuring you always have the care you need.
Some Cigna plans can be slightly more expensive than many mentioned above, but the bonuses can compensate for them. They also have cheaper options with zero premiums if you need them.
TIP
Choosing the right Medicare Advantage plan can seem overwhelming. However, there are lots of tools to assist with your evaluation. You can also talk with an insurance agent who can help you with the process.
Types Of Medicare Advantage Plans
There are several types of Medicare Advantage plans, and some are more common than others. The most common plans are the health maintenance organization (HMO) and preferred provider organization (PPO) plans, which have some differences.
- With an HMO, you are usually limited to the providers within the network. Your insurance company will provide a list of doctors and facilities in their network. If you choose to receive care at a facility that is out of the network, then you will likely be required to pay for the entire bill out of pocket.
- A PPO plan is similar but more flexible. In-network providers with a PPO plan agree to accept contracted service rates. You will typically see lower copays and deductibles when using a provider in your network. If you visit an out-of-network provider, your costs will be higher.
However, you should not be stuck with the entire bill. That provider might charge more for their service, and your insurance policy might cover less of the bill. However, your policy generally will still cover a portion of the bill, but you probably will have a higher copay and deductible when the provider is outside your network.
- Another type of plan is the Special Needs Plan, or SNP. These plans are typically geared toward individuals in various situations.
- First, if you have a chronic condition like diabetes, these plans can offer significant benefits that will help you with the cost of treatments.
- These plans are also commonly provided to individuals who qualify for Medicare and Medicaid.
If you find yourself in that situation, you might even have a healthcare professional or social worker recommending one of these plans. They can be a great way to manage all your healthcare needs from both programs in a single spot.
- Private Fee-For-Service (PFFS) plans are not as standard and may or may not include a provider network. If they do, out-of-network providers are generally required to accept Medicare reimbursement and your plan policy’s details.
- These plans do not usually include prescription drug coverage. You do not have to choose a primary care doctor and do not need a referral to see specialists under these plans.
However, you will want to make sure that your doctor or hospital agrees to treat you under this plan and accepts the payment laid out in the plan for the service. It would help to verify this before obtaining treatment, as you might otherwise be stuck with a larger bill than expected.
- A Medical Savings Account (MSA) is another relatively rare type of plan. For those familiar with employer-sponsored health insurance plans, this would be similar to a Health Savings Account used with a high-deductible plan.
- Money is deposited into the account each month, which can be used for qualified medical expenses, such as coinsurance payments.
- HMO Point-Of-Service (POS) plans are another type of Medicare Advantage plan that you might find available. These plans offer a hybrid HMO plan, making it more similar to a PPO. With a traditional HMO, you can only visit in-network providers. However, the POS plan allows you to see providers outside your network if you are willing to pay more for the service.
- These plans typically have separate deductibles for in-network versus out-of-network care.
Many people decide to purchase a Medicare Supplement insurance plan in addition to these plans. These plans are typically purchased in place of a Medicare Advantage plan. For those who decide to enroll in Original Medicare, these supplement plans can offer many additional benefits, like dental and vision coverage or help with out-of-pocket expenses. Similarly, Medigap plans can help offset the costs of copays and deductibles, and those plans often provide additional coverage that Original Medicare does not offer.
How To Choose The Best Medicare Advantage Plan
Once eligible for Medicare, you might dread the daunting task of selecting a plan. You need to take a few steps to find and enroll in the best Medicare Advantage plan for your situation. You should make sure that you consider the various factors that will affect your costs and the health care options that you have. Here is how you should choose the best plan:
Average Cost Of Medicare Advantage Plans
Medicare Advantage plan costs vary based on the plan type and coverage details. Some plans do not require a monthly premium, while others have more expensive premiums but lower copays and deductibles. Most people pay about $20 per month for a Medicare Advantage plan. You will find that some plans cost as much as $50 per month, but they generally include many benefits and lower costs for services.
The Bottom Line
There are many different Medicare Advantage plans, each with pros and cons. When it comes to selecting a plan, you should determine the one that is right for you based on your situation.
There is no one-size-fits-all approach to health care. Consider the plan’s overall costs and provider availability, and pick the one that best suits your needs.
Frequently Asked Questions
Aetna is often considered one of the best Medicare Advantage plan providers on the market today. They have low costs, higher customer satisfaction, and a vast network of providers. In addition, Blue Cross Blue Shield and Cigna also offer great plans and have millions of members enrolled. The best plan is the one that works best for you, so it needs to be specific to your needs.
It depends on the details of the specific plan. Some plans include dental and vision coverage, while some do not. Other plans include gym memberships or hearing benefits, while others do not.
Typically, nursing home care is not covered by any of the plans. For specific coverage details and questions, you would need to check your policy details.
Some Medicare Advantage plans follow the cost-sharing model that provides for zero monthly premiums. These plans usually include higher deductibles and copayments.
This means you will pay more when you visit the doctor or have a medical service performed. Plans that charge higher premiums often allow you to receive treatments at a lower cost.
Medicare Advantage Plans allow you to manage your Part A, Part B, and Part D coverage together in a single plan. You can also purchase additional services like dental or vision coverage.
Medigap plans exist to help you with out-of-pocket expenses or items not covered by Medicare. These plans are purchased by people enrolled in Original Medicare.
Medigap plans can help with copayments, deductibles, or payment for a service not covered by Medicare.
Medicare Advantage Plans allow you to manage your Part A, Part B, and Part D coverage together in a single plan. You can also purchase additional services like dental or vision coverage.
On the other hand, Medicare Supplemental plans are purchased in conjunction with Original Medicare. These plans are separate, but they provide additional benefits, such as the aforementioned dental and vision coverage.
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